Combined Use of Chinese Medicine with Allogeneic Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia Patients

被引:0
作者
叶宝东 [1 ]
张翔 [1 ]
邵科钉 [1 ]
陈丹 [1 ]
张宇 [1 ]
吴迪炯 [1 ]
俞庆宏 [1 ]
沈建平 [1 ]
沈一平 [1 ]
周郁鸿 [1 ]
机构
[1] Hematology Department,The First Affiliated Hospital,Zhejiang University of Traditional Chinese Medicine
关键词
severe aplastic anemia; allogeneic; hematopoietic stem cell; transplantation; Chinese medicine;
D O I
暂无
中图分类号
R556.5 [再生障碍性贫血和骨髓硬化性贫血];
学科分类号
1002 ; 100201 ;
摘要
Objective:To determine the effect of combined treatment with Chinese medicine(CM) and allogeneic hematopoietic stem ceil transplantation(allo-HSCT) on patients with severe aplastic anemia(SAA).Methods:Eleven patients were treated with CM plus ailo-HSCT.Nine patients received a conditioning regimen consisting of fludarabine(Flu),anti-thymocyte globulin(pig ALG),or anti-lymphocyte globulin(Rabbit ATG) and cyclophosphamide(CY),and two patients received pig ALG and CY.All patients were treated with Kidney(Shen)-reinforcing,blood-activating,and stasis-removing(KBS) herbal preparation beginning at 1 week before transplantation and ending at 8 weeks after transplantation.Chimerism status was assessed by analyzing short tandem repeat(STR) polymorphisms.Results:All patients recovered hematopoietic function and none had graft failure.The median number of days required for the absolute neutrophil count(ANC) increased to >0.5× 10;/L was 15 days(12-22 days) and for spontaneous platelet recovery to >20×10;/L without post-transplantation transfusion was 17 days(15-27 days).Nine patients were longterm survivors and achieved full donor chimerism.The overall cumulative incidence of acute graft versus host disease(GVHD) grades Ⅰ-Ⅱ and Ⅲ-Ⅳ was 18.2%(2/11) and 9.1%(1 /11),respectively.The overall accumulated incidence of chronic GVHD was 27.3%and all patients had limited chronic GVHD.At a median follow-up time of 32 months(range:12-97 months),9 patients were still alive.The estimated 5-year overall survival(OS) rate was 81.8%.The incidence of treatment-related mortality,2-year post-transplantation,was 18.2%.Two patients died from GVHD after transplantation.Conclusion:Treatment with the KBS formulation may reduce the rate of graft failure and treatmentrelated mortality and improve the rate of OS in SAA patients with allo-HSCT.
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页码:903 / 909
页数:7
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